Overview
💊 Broad-Spectrum Antibacterial: Used for adults, children, and infants over 3 months for treating and preventing uncomplicated UTIs or pyelonephritis.
📅 Duration: Treatment lasts 3 to 7 days; some may use a daily dose for recurrent UTIs.
Potential Risks
🫁 Pulmonary Reactions:
Acute: Fever, chills, cough, chest pain, dyspnoea, pulmonary infiltration, pleural effusion, eosinophilia.
Subacute/Chronic: Documented pulmonary damage.
🩸 Hepatic Reactions:
Rare but Serious: Cholestatic jaundice, chronic active hepatitis, autoimmune hepatitis, hepatic necrosis.
Important Update
📅 April 2023: MHRA issued a drug safety update.
⚠️ Alert: Be vigilant for pulmonary and hepatic adverse reactions.
📝 Case Reports: Acute pulmonary damage and respiratory failure reported; another case of long-term pulmonary damage.
Hepatic Reactions
🧐 Vigilance: Monitor for signs of liver dysfunction, especially in long-term use.
🧪 Biochemical Tests: Watch for changes indicating hepatitis or liver injury.
⛔ Immediate Action: Discontinue nitrofurantoin if hepatitis occurs.
Advice for Healthcare Professionals
⚠️ Caution: Use carefully in patients with pulmonary disease or hepatic dysfunction.
📖 Patient Information: Ensure patients read the leaflet on possible symptoms and seek medical advice if they occur.
🟨 Yellow Card Scheme: Report suspected adverse drug reactions.
Advice for Patients and Caregivers
🫁 Lung Symptoms: Seek medical help if you experience trouble breathing, shortness of breath, lingering cough, coughing up blood or mucus, or chest pain.
🩸 Liver Symptoms: Seek medical help if you develop yellowing of the skin or eyes, upper right abdominal pain, dark urine, pale stools, itching, or joint pain.
Pulmonary Damage
⏳ Monitoring: Long or short-term use can cause damage; closely monitor especially elderly patients on long-term therapy.
🚨 Action: Discontinue nitrofurantoin immediately if pulmonary damage symptoms occur.
References:
1. MHRA (2023). Nitrofurantoin: reminder of the risks of pulmonary and hepatic adverse drug reactions, Drug Saftey Update. Available at Nitrofurantoin: reminder of the risks of pulmonary and hepatic adverse drug reactions - GOV.UK (www.gov.uk). Accessed 3 April 2024).
2. Summary of Product Characteristics and Patient Information Leaflets. (2024). Nitrofurantoin. Available at https://www.medicines.org.uk/emc/search?q=Nitrofurantoin+ . Accessed 3 April 2024.
3. Yellow Card Scheme (2024). Yellow Card reporting site, Medicines and Healthcare Products Regulatory Agency. Available at https://yellowcard.mhra.gov.uk/. Accessed 3 April 2024.
Comments